Individual
GARY DAVID SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1879 HIDDEN TRAIL LN, WESTON, FL 33327-1456
(305) 469-9041
Mailing address
1879 HIDDEN TRAIL LN, WESTON, FL 33327-1456
(305) 469-9041
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO-0002363
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390143200
—
FL
01
—
65318
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/19/2006
Last updated
11/01/2016
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